Consultant ENT, Head and Neck and Thyroid Surgeon

Thyroidectomy

What is a thyroidectomy?

A thyroidectomy is the surgical removal of all or part of the thyroid gland.

Click here to link to a document on recover from thyroid surgery by the Royal College of Surgeons of England.

What does the thyroid gland do?

The thyroid, located at the base of your neck, makes a hormone that is sent into your bloodstream. The thyroid gland makes this hormone from iodine. Iodine is absorbed from the foods we eat.

The thyroid hormone controls the speed of your metabolism. The pituitary gland (located in your brain) controls how much thyroid hormone to make. It does this by making thyroid stimulating hormone (TSH). TSH tells the thyroid gland to make more or less thyroid hormone.

Problems with the thyroid gland

Hypothyroidism
An under-active thyroid is called hypothyroidism. The thyroid produces less thyroxine. This makes the pituitary gland send more TSH into the bloodstream to get the thyroid gland to make more hormone.

Common symptoms of hypothyroidism:
Weight gain
Feeling cold
Dry skin, hair, and nails
Feeling tired
Hyperthyroidism
An over-active thyroid is called hyperthyroidism. The thyroid gland makes too much thyroid hormone. The pituitary gland decreases the amount of TSH in the blood.

Common symptoms of hyperthyroidism:
Heat intolerance
Feeling jittery or irritable
Fast heart rate
Losing weight without dieting
Muscle weakness, fatigue
Nodules
Thyroid nodules can be either solid or cystic (fluid filled). Most of the time, your thyroid works normally if you have nodules. Most nodules are not cancerous. However, your doctor might take a sample of the cells in the nodule. This is called a fine needle aspiration. This sample will be examined to make sure there are no cancer cells.

Goitre

This is an enlargement of the thyroid gland. You might feel swelling or enlargement in the neck. It can become larger because your thyroid is trying to make more thyroid hormone. Also, in hyperthyroidism the cells grow faster, which causes the thyroid to grow and make more thyroid hormone than the body needs.

What if I need surgery?

Surgery might be necessary to remove a large goitre or nodule. Surgery might also be needed to remove a hyperthyroid gland that cannot be treated with medicine, or for thyroid cancer.

What are the risks of surgery?

The risks of surgery are minimal, but might include:

Blood loss
Infection
An occasional patient might have transient hoarseness (~6%), but this is rarely permanent (~3%).
If there is thyroid cancer, you might require additional therapy.
If at the whole gland is to be removed then there is a risk of low calcium levels from disruption to the blood supply of the parathyroid glands. (4 pea sized glands that sit behind the thyroid, 2 on either side, and regulate the body’s calcium levels.)

What occurs during surgery?

You will be given a general anaesthesia to relax your muscles, prevent pain, and make you fall asleep. An incision is made along a crease in the base of your neck. Your surgeon might remove part of the thyroid (lobectomy), most of the gland (subtotal), or all of the gland (total thyroidectomy).

After the surgery

You are usually watched in the hospital overnight.
You will have a cosmetically acceptable scar on the front of your neck.
You might be required to take thyroid hormone medication.